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From 3by5 to Universal Access to HIV/AIDS Treatment: AMDS
Technical Briefing Seminar for Consultants on Procurement and Supply Management for HIV, TB
and Malaria
30 January 2006
Copenhagen
Peter Graaff, AMDS, HIV
2AMDS
Content
Procurement and Supply Management• Issues• Tools
Aids Medicines and Diagnostics Service• Partners• Activity Areas
From 3by5 to Universal Access• Investment• Coordination
3AMDS
Drug procurement is more then "shopping" Procurement Cycle
DemandCreation
SupplierAgreements
FinancingReceipt, Storage,
Distribution
Forecasting
QualityAssurance
EffectiveUse
ProductProcurement
ProductSelection
Monitoring
4AMDS
A moving goalpostFrom procurement to supply management to……
Price
5AMDS
A moving goalpost From procurement to supply management to……
Price
6AMDS
A moving goalpost From procurement to supply management to……
Procurement
•What?•Where?•How much (quantification)?• IP barriers
•Patents•Bilateral trade agreements
•Registration (fast track)•Quality (PQ)?
7AMDS
A moving goalpost From procurement to supply management to……
Procurement
•What?•Where?•How much (quantification)?• IP barriers
•Patents•Bilateral trade agreements
•Registration (fast track)•Quality (PQ)?
8AMDS
A moving goalpost From procurement to supply management to……
Supply management
•Customs clearance•Volume •Expiry & stock-outs•Information flow•Task shifting•……..
9AMDS
A moving goalpost From procurement to supply management to……
Supply management
•Customs clearance•Volume •Expiry & stock-outs•Information flow•Task shifting•……..
10AMDS
A moving goalpost From procurement to supply management to……
Adherence
• Rational use•Patient tracking•Side effects•Community involvement•………….
11AMDS
A moving goalpost From procurement to supply management to……
price and procurement
• Increasing lead times with increasing chances of wastage• Global capacity• IP barriers
•Patents•Bilateral trade agreements
•…………..
12AMDS
Content
Procurement and Supply Management• Issues• Tools
Aids Medicines and Diagnostics Service• Partners• Activity Areas
From 3by5 to Universal Access• Investment• Coordination
13AMDS
Too much work and too little time
Build on existing capacityDevelop the AMDS as a network with WHO
taking on secretariat functions
14AMDS
Initiatives by the AMDS and its partners
15AMDS
PartnersUN Agencies
• WHO, UNICEF, World Bank, UNAIDS, UNFPA, UNDP
Technical organizations and donor agencies• Centrale Humanitaire Medico-Pharmaceutique, Clinton
HIV/AIDS Initiative, Commonwealth Pharmaceutical Association, Crown Agents, Ecumenical Pharmaceutical Network, GFATM, IDA, JSI, MSH, ESTHER, USAID
Observers• MSF, US State Department (OGAC/PEPFAR),Bill and
Melinda Gates Foundation
Secretariat• AMDS unit of HIV Department of WHO
•National•Regional •Global
•PSM / TCM / HIV
16AMDS
AMDS partnerstake responsibility for:
Procurement UNICEF, IDA, CHMP and WHO/CPS • Stockpile development
"Normative" activities• Prequalification• Monograph development• Forecasting and quantification tool development• Supply chain management system development
Operational work• Country level staffing• Capacity building• Technical support
17AMDS
Strategic information
Price Information System
Patent Status Database
ARV Market Intelligence
Inform Local Productionof ARVs
Market Forecast
AMDS website
Regulatory Status Database
API price, capacity &quality/specification info
ARV production costing
Global ARV price reporting mechanism
Key activity in
2006
www.who.int/3by5/amds
18AMDS
Global price reporting mechanismhttp://www.who.int/3by5/amds/price/hdd/
19AMDS
Technical support for PSM
Tools
Planning
Capacity building
PSM workshops• GFATM and WB recipients• Consultant briefing
national capacity building plans
national levels PSM coordination bodies
IMAAI training manual for facility level PSM
Country level assessments (including local production)
inventory of training activities
Harmonized monitoring systemfor reporting to donors
TA for identified "bottlenecks"
20AMDS
21AMDS
Content
Procurement and Supply Management• Issues• Tools
Aids Medicines and Diagnostics Service• Partners• Activity Areas
From 3by5 to Universal Access• Investment• Coordination
22AMDS
Too much work and too little time
Build on existing capacityDevelop the AMDS as a network with WHO
taking on secretariat functions
Moving from 3by5 to universal accessToo much work and tool little time…….. and
now more then ever at country level
23AMDS
What next?PSM in the context of universal access
National coordinationIntegration
• Universal access requires investment in the health (care delivery) system
Opportunity• HIV/AIDS as the engine to develop the
pharmaceutical sector
Investment• Spending, say 15%, of the value of the product
on its delivery to the client is normal but systematically ignored
24AMDS
Coordination
versus
Fragmentation
What next?PSM in the context of universal access
The Global Task Team (GTT)
UN coordination and cooperation at country level
25AMDS
National PSM Coordination BodyPossible activities
Regular information sharing on PSM• Current activities• Strategic info (e.g. prices, patent status, local production potential)
Harmonization of country-level PSM planning/budgeting, reporting, implementation for ARV supply• One system for drug management for multiple donor streams
Training & Implementation Tools• Harmonise Supply Chain Management and Monitoring systems • Facility-level guidelines on stock management and reporting• Common country-level forecasting tool
Common agenda to address HR gap in pharmaceutical sector
A code of conduct for the sales and distribution of ARVs
26AMDS
27AMDS
For further information please visit the AMDS website
http://www.who.int/3by5/amds/en/
or send an e-mail to
[email protected] (unit) or [email protected] (direct)
